Wednesday, May 20, 2015

Alka Kanaya, MD















JAHA: Tell us about the key findings from your recent article in JAHA.

Dr. Kanaya: We found that brachial artery flow mediated dilation (FMD) results differed from endothelial function biomarkers for those with pre-diabetes.  While biomarkers of endothelial function (PAI-1, E-selectin, sICAM-1, and vWF) were more uniform in association with glucose levels with higher levels of biomarkers associated with higher glucose levels.  However, the pattern of association with FMD was different—with the pre-diabetes IFG group having higher FMD levels than those with normal or diabetic glucose levels. This was most notable in whites with normal BMI.


JAHA: What are the major implications of this work?

Dr. Kanaya: This discordance between FMD and biomarker results raises the possibility of differential effects of insulin signaling in the endothelium vs. the skeletal muscles or other organs. It may also give us some clues about why some studies have found harmful associations between IFG and future events while others have not. 


JAHA: How did you get the idea to do this study?

Dr. Kanaya: I am interested in studying what factors explain higher prevalence of diabetes in ethnic minority groups vs. European white populations. We are studying South Asians in a prospective cohort study to determine etiologic and prognostic factors associated with diabetes and CVD. Endothelial function was a novel aspect worth studying in South Asians and comparing them to other US ethnic groups.


JAHA: What was your biggest obstacle in completing this study?

Dr. Kanaya: The most difficult part of this study was to understand and explain the novel findings with the differential effects observed by the FMD and the endothelial biomarkers for the IFG group.


JAHA: What was your most unexpected finding?

Dr. Kanaya: See above.


JAHA: What do you plan to do next, based on these current findings?

Dr. Kanaya: We are conducting a larger prospective cohort of 900 South Asians currently (called the Mediators of Atherosclerosis in South Asians Living in America study) which has been created to be parallel in methods and measures to the MESA study. We plan to remeasure endothelial function in this larger study to confirm our original findings.  We will also be examining prospective associations of endothelial function with diabetes incidence in both MESA and MASALA. 


JAHA: What do you like to do in your free time?  

Dr. Kanaya: I like to travel internationally with my family, cook and practice yoga.


JAHA: What is your favorite sports team or musical group? 

Dr. Kanaya: The San Francisco 49ers, Favorite band is U2.


Profile originally published February 26, 2013






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